Personality Disorders

While symptoms vary depending on the specific personality disorder, they often encompass a wide range of emotional, cognitive, and behavioral patterns that significantly impact a person's life. 

Emotional symptoms

Below are potential emotional symptoms of personality disorders: 

• Intense and unpredictable mood swings
• Chronic emptiness or loneliness
• Difficulty managing anger or frustration
• Inappropriate or extreme emotional reactions to situations
• Overwhelming fear of abandonment or rejection
• Difficulty trusting others and forming close relationships

Cognitive signs and symptoms

Personality disorders can also affect the mind through the following symptoms: 

• Distorted self-image, fluctuating between idealizing and devaluing oneself or others
• Persistent negative thoughts about oneself or others
• Difficulty concentrating or staying focused
• Disassociation or disconnect from oneself or reality
• Strong beliefs that are resistant to change, even in the face of contradictory evidence

Behavioral signs and symptoms

The way personality disorders impact behavior is varied, but individuals may experience the following behavioral symptoms: 

• Impulsive and risky behaviors, such as substance use, reckless driving, or excessive spending
• Self-harming behaviors, including suicidal behavior
• Tendency to engage in unstable and intense relationships
• Social isolation or avoidance of social situations
• Frequent conflicts with others due to misunderstandings or perceived slights

Interpersonal symptoms

Because personality disorders significantly impact personality, they can also affect relationships, such as through the following symptoms: 

• Difficulty understanding and empathizing with others' emotions
• Challenges maintaining boundaries in relationships
• Behaviors that may appear manipulative or controlling, often arising from significant emotional distress and unmet needs
• A chronic fear of rejection, leading to constant seeking of reassurance or validation
• Tendency to blame others for difficulties

Due to the nature of the symptoms, individuals with personality disorders may not be aware of their condition or find it challenging to seek help. While early symptom recognition can be helpful, personality disorders are often diagnosed based on a pervasive pattern of behavior that leads to significant distress or impairment in various areas of life.

The development of personality disorders is believed to be influenced by a combination of genetic, environmental, and psychological factors. While the exact causes may not be fully understood, several common causes and risk factors have been identified through research and clinical observations, including the following:

• Genetic predisposition: A family history of personality disorders or other mental health conditions may increase the risk of developing a personality disorder.
• Neurobiological factors: Abnormalities in brain structure and function, particularly in areas related to emotional regulation and impulse control, have been associated with personality disorders.
• Early life experiences: Traumatic events, neglect, or unstable family environments during childhood can contribute to the development of maladaptive coping mechanisms and personality traits.
• Inherited temperament: Certain personality traits and temperament from birth may interact with environmental factors to increase the risk of developing a personality disorder.

Common risk factors

Below are potential risk factors for the development of any personality disorder: 

• Family history: Having a family member with a personality disorder or other mental health conditions increases the likelihood of developing one.
• Childhood trauma: Experiencing abuse, neglect, or other traumatic events during childhood can be a significant risk factor.
• Substance use: Substance use can exacerbate personality disorder symptoms and hinder effective treatment.
• Chronic stress: Prolonged exposure to high levels of stress may contribute to the development of personality disorders.
• Lack of supportive relationships: A lack of positive and stable relationships in childhood and adulthood may increase vulnerability to personality disorders.

Trauma triggers and personality disorders 

For personality disorders related to trauma, like borderline personality disorder, specific triggers can exacerbate symptoms and lead to emotional dysregulation. Common triggers for trauma-related personality disorders include:

• Abandonment or rejection: Being rejected or fearing abandonment may trigger intense emotional reactions and efforts to avoid perceived abandonment.
• Intense interpersonal conflicts: Conflict or perceived criticism from others can cause feelings of anger and sadness or thoughts of worthlessness.
• Reminders of past trauma: Situations or stimuli that resemble past traumatic events can evoke strong emotional responses.
• Being overwhelmed: Being overwhelmed by stress, emotions, or responsibilities may lead to impulsive or self-destructive behaviors as a coping mechanism.

The treatment of personality disorders often involves a multi-faceted approach, combining various therapeutic interventions, medication (if necessary), and self-care strategies. The primary goal of treatment is often to help individuals manage their symptoms, improve their overall functioning, and develop healthier coping mechanisms to lead more fulfilling lives. Providers can tailor the treatment plan to the specific type and severity of the personality disorder, considering individual needs and circumstances. For example, the treatment plan may be different for dependent personality disorder, histrionic personality disorder, and paranoid personality disorder. While personality disorders are ongoing, treatment can improve functioning and quality of life.

Medication

Antidepressants, mood stabilizers, and antipsychotic medications may be used in conjunction with therapy in personality disorders to alleviate symptoms and improve overall functioning. Consult a medical doctor before starting, changing, or stopping medication for any condition. This information is not a replacement for medical advice or diagnosis. 

Other treatment options

Other ways to receive treatment for personality disorders may include: 

• Hospitalization: In severe cases, when individuals are at risk of harming themselves or others, short-term hospitalization may be recommended to ensure their safety and provide intensive stabilization.
• Supportive services: Case management and other supportive services may help individuals with personality disorders find resources, build life skills, and maintain stability in their daily lives.

Self-care 

Below are forms of self-care that may be helpful alongside treatment for personality disorders: 

• Mindfulness and meditation: Practicing mindfulness techniques can help individuals become more aware of their thoughts and emotions, fostering greater self-acceptance and emotional regulation.
• Physical activity: Regular exercise can benefit physical and mental well-being, reducing stress and improving mood.
• Healthy lifestyle choices: Maintaining a balanced diet, getting adequate sleep, and avoiding substance use can positively impact mental health.
• Social support: Building and maintaining supportive relationships with friends, family, or support groups can provide invaluable emotional support and understanding.

An integrated treatment approach involving therapy, psychiatry, and self-care strategies can be highly effective in managing personality disorders. By addressing the root causes, developing healthier coping mechanisms, and fostering supportive relationships, individuals with personality disorders may experience improved quality of life and mental well-being.

Treating various types of personality disorders often requires a comprehensive therapeutic approach involving the support of mental health professionals. Certain online therapy platforms, such as BetterHelp, offer the ability to connect individuals living with personality disorders with therapists or counselors who meet their specific needs.

Additional resources include the following: 

• Personality Disorders Awareness Network (PDAW) (which has information on borderline personality disorder, narcissistic personality disorder, and antisocial personality disorder)
• Suicide and Crisis Lifeline (988)
• Substance Abuse and Mental Health Service Administration (SAMHSA)
• National Education Alliance for Borderline Personality Disorder

For those experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

For those with thoughts of suicide, contact 988 Suicide & Crisis Lifeline at 988. Please also see our Get Help Now page for more immediate resources.

For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

Please see our Get Help Now page for more immediate resources.

Despite often going unnoticed in regular practice, research studies have demonstrated that personality disorders are widespread, affecting nearly 6% of the global population with no consistent variation between countries. Additionally, there is increasing evidence that specific psychological treatments hold value for this group of disorders.

Below are several statistics on personality disorders: 

• Personality disorders affect approximately 10% of the general population, making them relatively common mental health conditions. 
• Borderline personality disorder, one of the most common personality disorders, affects about 1% to 2% of the population. 
• 40% to 60% of individuals with personality disorders seek professional treatment.
• Research indicates that therapy can be highly effective in treating personality disorders, with up to 80% of clients showing improvement in symptoms and overall functioning.